Emotional Partner Violence as a Predictor of Gynecological Pathology and Symptoms in Women of Reproductive Age

Introduction. Emotional abuse by an intimate partner is a common form of domestic violence that has a pronounced negative impact on women’s reproductive and mental health. Despite the high prevalence, the influence of the psychological component on the formation of gynecological pathology in Russian science has not been sufficiently studied. 
Objective. To study emotional abuse as a factor in the development of gynecological problems and symptoms in women of reproductive age, as well as as an independent predictor of delayed medical treatment.
Materials and Methods. The study involved 61 women aged 18 to 40 years (mean age 29.7 years). The emotional Abuse Questionnaire (EAQ) with the “isolation” and “humiliation” subscales, the Hospital Anxiety and Depression Scale (HADS), the Holmes-Rage Stress Event Scale (SRRS), and the author’s questionnaire for assessing gynecological status (presence of diagnoses, symptoms over the past year, and frequency of visits to the doctor) were used for diagnosis. Statistical data processing was performed using the Mann-Whitney U-test and binary logistic regression analysis (Wald method), while controlling for additional variables in the SPSS 27 program. 
Results. It was found that 57.4% of participants postponed a visit to the gynecologist. The most common problems were menstrual disorders (47.5%) and endometriosis (32.8%). Women who postponed the visit showed statistically significantly higher levels of isolation, humiliation, anxiety, and depression compared to the timely treatment group (p < 0.01). Binary logistic regression revealed that the “Isolation” scale is a stable predictor of postponement of a visit in the control of anxiety (p = 0.019) and depression (p = 0.026), and the “Humiliation” scale – in the control of anxiety (p = 0.029). Increasing the isolation score by 1 point increases the chance of postponing a visit by about 5%. However, anxiety and depression alone did not make a significant independent contribution to the models. 
Discussion. The data obtained support the hypothesis that psychological pressure of a partner acts as an independent risk factor for avoiding medical care, regardless of the overall level of affective distress. Isolation deprives a woman of social and informational support, and chronic humiliation creates a sense of shame and lowers self-esteem, making gynecological examination psychologically difficult. 

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